# FONDREN DENTAL PA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** FONDREN FAMILY DENTAL
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205213816
- **Authorized official:** MR. RAZA RAHGOZARD (DENTIST)
- **Authorized official phone:** (210) 777-1225

## Contact information

- **Practice address:** 3400 FONDREN RD, HOUSTON, TX 77063
- **Practice address phone:** (281) 974-3850
- **Mailing address:** 3400 FONDREN RD, HOUSTON, TX 77063-5650
- **Mailing address phone:** (281) 974-3850

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 29010 | TX | Yes |

## Other

- **Enumeration date:** 05/04/2015
- **Last updated:** 05/04/2015